Comparison of Percutaneous Kyphoplasty with or without Pedicle Screw Fixation in Osteoporotic Thoracolumbar Vertebral Fractures: A Retrospective Study

Abstract

Background. Osteoporotic thoracolumbar compression fractures have become a great social burden due to the aging tendency of population. This study is aimed at comparing the clinical and radiological outcomes of percutaneous kyphoplasty with or without pedicle screw fixation in patients with osteoporotic thoracolumbar fractures. Hypothesis. There is a difference in clinical outcomes between percutaneous kyphoplasty with pedicle screw fixation and percutaneous kyphoplasty. Methods. This retrospective study included 87 patients who received percutaneous kyphoplasty with or without pedicle screw fixation between October 2015 and October 2017 at Ningbo No.6 Hospital and were followed for 2 years. A total of 40 patients received percutaneous kyphoplasty with pedicle screw fixation (PKPF group), and the other 47 patients had percutaneous kyphoplasty only (PKP group). The outcomes were measured using the visual analogue scale (VAS), Oswestry Disability Index (ODI), Cobb angle (CA), and anterior vertebra height rate (AVHr), which were calculated at preoperative admission and each follow-up visit. Complications including postoperative back pain, refracture, and fixation failure were collected from medical records. Results. There was no significant difference in baseline characteristics or preoperative data between the two groups ( p < 0.05 ) but significantly better improvements in VAS, ODI, CA, and AVHr at 12- and 24-month follow-up visits in the PKPF group compared with those of the PKP group. 23 (48.9%) patients in the PKP group had complications, whereas only 5 (12.5%) patients in the PKPF group presented complications including 2 postoperative back pain and 1 fixation failure ( p = 0.04 ). Conclusions. PKPF obtained longer correction and better improvement in VAS, ODI, and CA in patients with osteoporotic thoracolumbar vertebral fractures than PKP.

Comparison of Percutaneous Kyphoplasty With or Without Posterior Pedicle Screw Fixation on Spinal Sagittal Balance in Elderly Patients With Severe Osteoporotic Vertebral Compression Fracture: A Retrospective Study

“…There have been some reports that secondary vertebral fractures after PVP or PKP, including further compression of previously treated vertebrae and new fractures in adjacent vertebrae (11,16,49,50). Kim and Rhyu (49) showed that the incidence of fractured vertebrae recollapse was 12.5%.…”

“…In the PKP group of this study, 10 (12.82%) of 78 patients had complications, including cement leakage (n = 3), fractured vertebrae recollapse (n = 2) and adjacent vertebral fracture (n = 5), these incidences are slightly lower than the abovementioned studies. In addition, Huang et al (16) reported that 23 patients with osteoporotic thoracolumbar fractures (48.9%) in PKP group had complications, including cement leakage (n = 10), fractured vertebrae recollapse (n = 12) and reoperation due to refractures (n = 2), and the complications in PPSF+KP group were significantly less (p < 0.05), including cement leakage (n = 2), wound infection (n = 1), and recollapse at the final follow-up (n = 2). In this study, 3 (20.51%) of 24 patients had complications, including cement leakage (n = 1), fractured vertebrae recollapse (n = 1) and adjacent segment fracture (n = 1), and there was no significant difference in the incidence of each complication between the two groups.…”

“…Some clinical studies have reported that PPSF combined with KP or vertebroplasty (VP) could be a good choice for patients with thoracolumbar OVCF, which can reduce the incidence of vertebral refractures and restore the height of the fractured vertebrae (15)(16)(17). So far, however, few studies have compared the prognosis of PKP and PPSF+KP in patients with thoracolumbar sOVCF, especially the long-term effect on spinal sagittal balance.…”

Association of IL-6 and TGF-β Gene Polymorphisms with the Risk of Thoracolumbar Osteoporotic Vertebral Compression Fractures

“…As the higher frequency complication of osteoporosis, osteoporotic vertebral compression fractures (OVCF) are the most common clinical fracture, and there are nearly 1.4 million new cases per year. 1 Epidemiology shows that the thoracolumbar vertebral body is the most common site for osteoporotic fractures, and the incidence of thoracolumbar OVCF accounts for 53% of all fragility fractures. 2 It can cause severe and long-term low back pain, even disability, and seriously affect the quality of life.…”

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

“…In recent years, various minimally invasive techniques have developed rapidly. Currently, minimally invasive pedicle screw internal fixation is used to restore the height of the compressed vertebral body in patients, which can make up for the insufficiency of traditional treatment and surgery [ 6 ]. In this study, we chose open and minimally invasive internal fixation with an arch nail to analyze the effect on the stress response of patients with vertebral fractures, hoping to improve the function of the lumbar spine and improve their ability to live, respectively, as reported below.…”